M1151 HCPCS Level II code: Patients with a history of heart transplant or with a left ventricular assist device (lvad)

M1151 is the HCPCS code for “Patients with a history of heart transplant or with a left ventricular assist device (lvad)” in CMS’s October 2026 release, in effect from Oct 1, 2026.

Official description

M1151

Patients with a history of heart transplant or with a left ventricular assist device (lvad)

Short description: Pt w/ hx trnsplt or lvad

HCPCS · United States

Medicare details

The indicators CMS publishes with M1151 in its October 2026 file. They describe Medicare’s handling, not another payer’s.

Medicare coverage
Carrier judgment
Medicare pricing
Service not separately priced by Part B (e.g., services not covered, bundled, used by Part A only, etc.)
Type of service
Medical care
BETOS category
Undefined codes
Added
Jan 1, 2023

Where M1151 sits

  1. 1M codesMedical services and quality measures
  2. 2Active code M1151Patients with a history of heart transplant or with a left ventricular assist device (lvad)

Source and release

Data release
HCPCS Level II · October 2026
Effective date
Oct 1, 2026
Publisher
CMS

This page is built from the HCPCS Level II catalog that Vero Codes reads when it suggests codes: Centers for Medicare & Medicaid Services’s October 2026 release, imported from the publisher’s file and checked against it. The description, notes and structured data come from the same record.

Frequently asked questions

What does HCPCS code M1151 mean?

M1151 is the HCPCS code for “Patients with a history of heart transplant or with a left ventricular assist device (lvad)” in CMS’s HCPCS Level II October 2026 release.

Does Medicare cover M1151?

CMS lists M1151’s Medicare coverage as “Carrier judgment” and its pricing as “Service not separately priced by Part B (e.g., services not covered, bundled, used by Part A only, etc.)”. Coverage and payment still depend on the patient, the setting, the documentation and the payer.

Which HCPCS Level II release does this page use?

It uses CMS’s October 2026 release, in effect from Oct 1, 2026 to Dec 31, 2026. It is a reference: confirm the code against the current list and the payer’s rules before you submit it.

M1145Most favored nation (mfn) model drug add-on amount, per dose, (do not bill with line items that have the jw modifier)M1146Ongoing care not clinically indicated because the patient needed a home program only, referral to another provider or facility, or consultation only, as documented in the medical…M1147Ongoing care not medically possible because the patient was discharged early due to specific medical events, documented in the medical record, such as the patient became…M1148Ongoing care not possible because the patient self-discharged early (e.g., financial or insurance reasons, transportation problems, or reason unknown)M1149Patient unable to complete the neck fs prom at initial evaluation and/or discharge due to blindness, illiteracy, severe mental incapacity or language incompatibility, and an…M1150Current or prior left ventricular ejection fraction (lvef) less than or equal to 40% or documentation of moderately or severely depressed left ventricular systolic functionM1152Patients with a history of heart transplant or with a left ventricular assist device (lvad)M1153Patient with diagnosis of osteoporosis on date of encounterM1154Hospice services provided to patient any time during the measurement periodM1155Patient had anaphylaxis due to the pneumococcal vaccine any time during or before the measurement periodM1156Patient received active chemotherapy any time during the measurement periodM1157Patient received bone marrow transplant any time during the measurement period